Telegraph article: Science hasn't answered all the questions on HIV

Dr Kimberly Smith, vice president of medical strategy at ViiV Healthcare, shares her experiences of a career spent working to find a cure for the disease.

“I'm a trouble maker,” admits Dr Kimberly Smith. But she’s a well-placed trouble maker – a former medical scientist, she’s now vice president of global medical strategy at ViiV Healthcare, a leading specialist HIV company that counts GSK as its majority shareholder.

This means she now gets to make the big decisions around research into HIV– the very issues for which, as a doctor, she used to hold companies to account.

“For instance, I can ensure research studies include enough women – since half of the people living with HIV are women – which didn’t always happen. “I want to see more drugs for children with HIV – that’s also an under-developed area,” she says. “ I am fortunate to work for a company that believes these are priorities to address.”

Some 36 million people live with the virus, and for each of them the experience will be different.

Dr Kimberly Smith

Dr Smith has devoted her entire career to fighting HIV. Back in what she calls “the bad old days” of the 1980s when the disease first emerged, she was appalled at how patients were treated.

“If you had HIV back then, it was almost unspeakable. This just tugged at my heartstrings.” But she also relished the intellectual challenge. “The science was fascinating. We were beginning to understand the virus, and what it did to the immune system, how it constantly mutates.”

Now, she’s fighting the mistaken belief that science has answered all the questions on HIV.

Today, someone living with HIV – in the developed world – can live a relatively normal life if they are on treatment. But that doesn’t mean that anti-viral medicines are without limitations – the drugs have side effects, and can become resistant to the virus.

And in the developing world, where diagnosis and access to treatment falls well below western standards, diseases such as TB can be deadly for patients, and people living with HIV are still ostracized.

We’ve made a tremendous amount of progress in terms of how the virus entwines with our DNA.

Dr Kimberly Smith

“We're not out of the woods when it comes to reducing the stigma – we are nowhere near seeing HIV in the same light as other chronic diseases such as diabetes,” she says.

Some 36 million people live with the virus, and for each of them the experience will be different. “Our philosophy is to try and meet the needs of every person living with HIV, even if that’s only a fraction of the population.

“Pharmaceutical companies want to develop blockbuster drugs – but we need to look after individuals too.”

Dr Smith is often asked for advice from younger women – as a leading scientist in her field – though as she admits, she never has a problem speaking up.

“You must step up and let your voice be heard.” Build your professional networks, she urges – as a young doctor working in infectious diseases, she took care to create and nurture relationships with more senior professionals she encountered.

In fact, it was her acquaintance with ViiV Healthcare’s chief scientific and medical officer Dr John Pottage 18 years earlier which led to her accepting her current role.

“We’d kept in touch. We trusted each other, and that relationship helped my career.”

Now two years into her post and focusing mainly on clinical trials, she has her feet firmly under the desk – but in the future she’d be interested to expand her expertise to make sure people have better access to medicines in harder-to-reach parts of the world.

And she believes that a cure for AIDS will be discovered within her lifetime.

“We’ve made a tremendous amount of progress in terms of how the virus integrates into the immune system, how it entwines with our DNA,” she says.